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Evaluation of mitral chordae tendineae length using four-dimensional computed

World Journal of Cardiology 2024年第5期16卷 274-281页

作者： Takuya Mori Satoshi Matsushita Terumasa Morita Abulaiti Abudurezake Junji Mochizuki Atsushi Amano Department of cardiovascular Surgery Juntendo University Faculty of MedicineTokyo 113-8421Japan Department of cardiovascular Surgery JACCT Japan Animal Cardiovascular Care TeamOsaka 533-0033Japan Department of radiology Minamino Cardiovascular HospitalTokyo 192-0918Japan

BACKGROUND Mitral valvuloplasty using artificial chordae tendineae represents an effective surgical approach for treating mitral regurgitation.Achieving precise measurements of artificial chordae tendineae length(CL)is an important factor in the procedure;however,no objective index currently exists to facilitate this measurement.Therefore,preoperative assessment of CL is critical for surgical planning and support.Four-dimensional x-ray micro-computed tomography(4D-CT)may be useful for accurate CL measurement considering that it allows for dynamic three-dimensional(3D)evaluation compared to that with transthoracic echocardiography,a conventional inspection method.AIM To investigate the behavior and length of mitral chordae tendineae during systole using 4D-CT.METHODS Eleven adults aged>70 years without mitral valve disease were evaluated.A 64-slice CT scanner was used to capture 20 phases in the cardiac cycle in electrocardiographic synchronization.The length of the primary chordae tendineae was measured from early systole to early diastole using the 3D image.The primary chordae tendineae originating from the anterior papillary muscle and attached to the A1-2 region and those from the posterior papillary muscle and attached to the A2-3 region were designated as cA and cP,respectively.The behavior and maximum lengths[cA(ma),cP(max)]were compared,and the correlation with body surface area(BSA)was evaluated.RESULTS In all cases,the mitral anterior leaflet chordae tendineae could be measured.In most cases,the cA and cP chordae tendineae could be measured visually.The mean cA(max)and cP(max)were 20.2 mm±1.95 mm and 23.5 mm±4.06 mm,respectively.cP(max)was significantly longer.The correlation coefficients(r)with BSA were 0.60 and 0.78 for cA(max)and cP(max),respectively.Both cA and cP exhibited constant variation in CL during systole,with a maximum 1.16-fold increase in cA and a 1.23-fold increase in cP from early to mid-systole.For cP,CL reached a plateau at 15%and remained elongated until end-systole,whereas for cA,aft

关键词： Mitral valve Chordae tendineae Computed tomography Four-dimensional Cardiac cycle

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Prognostic value of cardiovascular magnetic resonance in immune checkpoint inhibitor-associated myocarditis:A systematic review and meta-analysis

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Cancer Innovation 2024年第3期3卷 22-32页

作者： Wenhua Song Nan Zhang Tonglian Lv Yang Zhao Guangping Li Gary Tse Tong Liu Tianjin Key Laboratory of Ionic-Molecular Function of cardiovascular Disease Department of CardiologyTianjin Institute of CardiologySecond Hospital of Tianjin Medical UniversityTianjinChina Department of radiology Second Hospital of Tianjin Medical UniversityTianjinChina School of Nursing and Health Studies Hong Kong Metropolitan UniversityHong KongChina Cardiac Electrophysiology Unit Cardiovascular Analytics GroupPowerHealth LimitedHong KongChina

Background:The role of surgery in metastatic breast cancer(MBC)is currently controversial.Several novel statistical and deep learning(DL)methods promise to infer the suitability of surgery at the individual level.Objective:The objective of this study was to identify the most applicable DL model for determining patients with MBC who could benefit from surgery and the type of surgery required.Methods:We introduced the deep survival regression with mixture effects(DSME),a semi-parametric DL model integrating three causal inference methods.Six models were trained to make individualized treatment recommendations.Patients who received treatments in line with the DL models'recommendations were compared with those who underwent treatments divergent from the recommendations.Inverse probability weighting(IPW)was used to minimize bias.The effects of various features on surgery selection were visualized and quantified using multivariate linear regression and causal inference.Results:In total,5269 female patients with MBC were included.DSME was an independent protective factor,outperforming other models in recommend-ing surgery(IPW-adjusted hazard ratio[HR]=0.39,95%confidence interval[CI]:0.19–0.78)and type of surgery(IPW-adjusted HR=0.66,95%CI:0.48–0.93).DSME was superior to other models and traditional guidelines,suggesting a higher proportion of patients benefiting from surgery,especially breast-conserving surgery.The debiased effect of patient characteristics,including age,tumor size,metastatic sites,lymph node status,and breast cancer subtypes,on surgery decision was also quantified.Conclusions:Our findings suggested that DSME could effectively identify patients with MBC likely to benefit from surgery and the specific type of surgery needed.This method can facilitate the development of efficient,reliable treatment recommendation systems and provide quantifiable evidence for decision-making.

关键词： breast surgery causal inference deep learning metastatic breast cancer

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Lysine demethylase 5B transcriptionally regulates TREM1 in human cardiac fibroblasts

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BIOCELL 2024年第7期48卷 1105-1113页

作者： CHUNLING LIANG JING CHEN XIAOJIE CHEN WEI YAN JIE YU Department of Emergency Wangjing Hospital of China Academy of Chinese Medical SciencesBeijing100102China Department of Cardiology State Key Laboratory of Cardiovascular DiseaseFuwai HospitalNational Center for Cardiovascular DiseasesChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing100102China Department of radiology Wangjing Hospital of China Academy of Chinese Medical SciencesBeijing100102China Department of Cardiology Wangjing Hospital of China Academy of Chinese Medical SciencesBeijing100102China

Background:A differential gene,triggering receptor expressed on myeloid cells 1(TREM1),was identiﬁed in blood sequencing datasets from myocardial infarction patients and healthy controls.Myocardialﬁbrosis following myocardial infarction signiﬁcantly contributes to cardiac dysfunction.Objectives:This study aimed to unveil the intrinsic regulatory mechanism of TREM1 in myocardialﬁbrosis.Methods:Mimicking pathology by angiotensin II(Ang II)treatment of human cardiacﬁbroblasts(HCFs),the impacts of TREM1 knockdown on its proliferation,migration,and secretion of the pro-ﬁbrotic matrix were identiﬁed.Using the Human Transcription Factor Database(HumanTFDB)website,lysine-speciﬁc demethylase 5B(KDM5B)was found to bind to the TREM1 promoter,which was further validated through luciferase reporter and chromatin immunoprecipitation(ChIP).By promoting KDM5B overexpression,its effect on the regulation of TREM1 was examined.Results:TREM1 knockdown suppressed the proliferation,migration,and secretion of the pro-ﬁbrotic matrix in HCFs upon Ang II treatment.KDM5B bound to the TREM1 promoter and upregulated its transcriptional expression.Furthermore,KDM5B overexpression reversed the regulation of the above cellular phenotypes by TREM1 knockdown.Conclusion:This study sheds light on the positive regulation of TREM1 by KDM5B,demonstrating their role in promoting myocardialﬁbrosis.Thisﬁnding provides a theoretical foundation for understanding disease pathology and potentially advancing the development of new targeted therapies.

关键词： Cardiac fibroblasts Fibrosis Myeloid cell receptor Migration Proliferation

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Epicardial adipose tissue in obesity with heart failure with preserved ejection fraction: cardiovascular magnetic resonance biomarker study

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World Journal of Cardiology 2024年第3期16卷 149-160页

作者： Ju-Wei Shao Bing-Hua Chen Kamil Abu-Shaban Ahmad Baiyasi Lian-Ming Wu Jing Ma Department of radiology The Affiliated Hospital of Yunnan UniversityKunming 650021Yunnan ProvinceChina Department of radiology Ren Ji HospitalSchool of MedicineShanghai Jiao Tong UniversityShanghai 200127China Department of radiology University of Toledo College of MedicineToledoOH 43623United States Department of radiology Wayne State University School of MedicineDetroitMI 48201United States Department of Endocrinology Ren Ji HospitalShanghai Jiao Tong University School of MedicineShanghai 200127China

BACKGROUND Obesity has become a serious public health issue,significantly elevating the risk of various complications.It is a well-established contributor to Heart failure with preserved ejection fraction(HFpEF).Evaluating HFpEF in obesity is crucial.Epicardial adipose tissue(EAT)has emerged as a valuable tool for validating prognostic biomarkers and guiding treatment targets.Hence,assessing EAT is of paramount importance.cardiovascular magnetic resonance(CMR)imaging is acknowledged as the gold standard for analyzing cardiac function and mor-phology.We hope to use CMR to assess EAT as a bioimaging marker to evaluate HFpEF in obese patients.AIM To assess the diagnostic utility of CMR for evaluating heart failure with preserved ejection fraction[HFpEF;left ventricular(LV)ejection fraction≥50%]by measuring the epicardial adipose tissue(EAT)volumes and EAT mass in obese patients.METHODS Sixty-two obese patients were divided into two groups for a case-control study based on whether or not they had heart failure with HFpEF.The two groups were defined as HFpEF+and HFpEF-.LV geometry,global systolic function,EAT volumes and EAT mass of all subjects were obtained using cine magnetic resonance sequences.RESULTS Forty-five patients of HFpEF-group and seventeen patients of HFpEF+group were included.LV mass index(g/m2)of HFpEF+group was higher than HFpEF-group(P<0.05).In HFpEF+group,EAT volumes,EAT volume index,EAT mass,EAT mass index and the ratio of EAT/[left atrial(LA)left-right(LR)diameter]were higher compared to HFpEF-group(P<0.05).In multivariate analysis,Higher EAT/LA LR diameter ratio was associated with higher odds ratio of HFpEF.CONCLUSION EAT/LA LR diameter ratio is highly associated with HFpEF in obese patients.It is plausible that there may be utility in CMR for assessing obese patients for HFpEF using EAT/LA LR diameter ratio as a diagnostic biomarker.Further prospective studies,are needed to validate these proof-of-concept findings.

关键词： Heart failure with preserved ejection fraction Epicardial adipose tissue Obesity Cardiac magnetic resonance

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Predictive value of bilirubin and serum γ-glutamyltranspeptidase levels in type-2 diabetes mellitus patients with acute coronary syndrome

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World Journal of Diabetes 2024年第1期15卷 34-42页

作者： Jie Chen Wan-Chao Zhang Xiao-Qiang Tang Ruo-Han Yin Tao Wang Xiao-Yu Wei Chang-Jie Pan radiology Department The Affiliated Changzhou No.2 People's Hospital of Nanjing Medical UniversityChangzhou 213164Jiangsu ProvinceChina radiology Department The People’s Hospital of WuQia CountyWuqia 845450Xinjiang Uygur Autonomous RegionChina

BACKGROUND cardiovascular disease is a major complication of diabetes mellitus(DM).Type-2 DM(T2DM)is associated with an increased risk of cardiovascular events and mortality,while serum biomarkers may facilitate the prediction of these outcomes.Early differential diagnosis of T2DM complicated with acute coronary syndrome(ACS)plays an important role in controlling disease progression and improving safety.AIM To investigate the correlation of serum bilirubin andγ-glutamyltranspeptidase(γ-GGT)with major adverse cardiovascular events(MACEs)in T2DM patients with ACS.METHODS The clinical data of inpatients from January 2022 to December 2022 were analyzed retrospectively.According to different conditions,they were divided into the T2DM complicated with ACS group(T2DM+ACS,n=96),simple T2DM group(T2DM,n=85),and simple ACS group(ACS,n=90).The clinical data and laboratory indices were compared among the three groups,and the correlations of serum total bilirubin(TBIL)levels and serumγ-GGT levels with other indices were discussed.T2DM+ACS patients received a 90-day follow-up after discharge and were divided into event(n=15)and nonevent(n=81)groups according to the occurrence of MACEs;Univariate and multivariate analyses were further used to screen the independent influencing factors of MACEs in patients.RESULTS The T2DM+ACS group showed higherγ-GGT,total cholesterol,low-density lipoprotein cholesterol(LDL-C)and glycosylated hemoglobin(HbA1c)and lower TBIL and high-density lipoprotein cholesterol levels than the T2DM and ACS groups(P<0.05).Based on univariate analysis,the event and nonevent groups were significantly different in age(t=3.3612,P=0.0011),TBIL level(t=3.0742,P=0.0028),γ-GGT level(t=2.6887,P=0.0085),LDL-C level(t=2.0816,P=0.0401),HbA1c level(t=2.7862,P=0.0065)and left ventricular ejection fraction(LEVF)levels(t=3.2047,P=0.0018).Multivariate logistic regression analysis further identified that TBIL level and LEVF level were protective factor for MACEs,and age andγ-GGT level were risk factors(P<0.05).CONCLUSION Serum

关键词： Acute coronary syndrome Type-2 diabetes mellitus Total bilirubin Major adverse cardiovascular events

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Juvenile cardiomyopathy with dystrophin deficiency

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Genes & Diseases 2024年第3期11卷 30-33页

作者： Yuhui Luo Qinglan Shu Yi Wang Min Gu Hao Zhang Siqi Hong Rui Wang Lixue Yin Department of Cardiology Chongqing General HospitalChongqing 401147China Department of cardiovascular Ultrasound and Noninvasive Cardiology Sichuan Provincial People's HospitalUniversity of Electronic Science and Technology of China(UESTC)ChengduSichuan 610072China Department of RadiologyChongqing General HospitalChongqing 401147China Department of Neurology Children's Hospital of Chongqing Medical UniversityChongqing 400014China School of Medicine Zunyi Medical UniversityZunyiGuizhou 563000China

Pseudohypertrophic muscular dystrophy is a lethal X-linked recessive neuromuscular disorder caused by mutations in the dystrophin gene.This gene encodes a cytoskeletal protein that is extensively expressed in muscle cells and that enables the strength,stability,and functionality of myofibers.Muscular dystrophy can be grouped into two different categories based on the mutational rate and clinical severity,Duchenne muscular dystrophy(DMD)and Becker muscular dystrophy(BMD).DMD is the most common and the more severe type of dystrophy.DMD patients usually become wheelchair-bound by the age of 12 years and die in their late teens to early twenties.^(1)In contrast,BMD is relatively less severe and the patients can potentially have alonger lifeexpectancy.

关键词： dystrophin dystrophy Becker

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Association between QRS voltages and amyloid burden in patients with cardiac amyloidosis

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Chinese Medical Journal 2024年第3期137卷 365-367页

作者： Jing-Hui Li Changcheng Li Yucong Zheng Kai Yang Yan Huang Huixin Zhang Xianmei Li Xiuyu Chen Linlin Dai Tian Lan Yang Sun Minjie Lu Shihua Zhao Department of Magnetic Resonance Imaging Fuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China Department of radiology Taian City Central Hospital(The Affiliated Taian City Central Hospital of Qingdao University)Tai’anShandong 271099China Department of radiology Tsinghua University HospitalTsinghua UniversityBeijing 100084China Department of radiology The Fifth People’s Hospital of Huai’anHuai’anJiangsu 223001China Department of radiology Geriatric Hospital of Nanjing Medical UniversityNanjingJiangsu 210000China Department of Cardiology Peking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Pathology Fuwai HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100037China

To the Editor:Cardiac amyloidosis(CA)is an infiltrative cardiomyopathy characterized by extracellular deposition of misfolded insoluble amyloid fibrils.^([1])Electrocardiography(ECG)is an essential diagnostic test characterized by low QRS voltages in CA,observed in 20–74%of patients.^([2])Cipriani et al^([3])reported that low QRS voltages could independently predict cardiovascular death.But the mechanisms underlying low QRS voltages in CA remain unclear.

关键词： amyloid patients death.

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Chinese consensus on the diagnosis and treatment of immunoglobulin light-chain cardiac amyloidosis

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Chinese Medical Journal 2024年第2期137卷 127-129页

作者： Kaini Shen Zhuang Tian Yajuan Gao Yining Wang Li Huo Jian Li Yun Zhang Shuyang Zhang On behalf of Chinese Society of Rare Diseases and Rare Diseases Branch of China Research Hospital Association Department of Hematology State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Cardiology State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Clinical Medicine Chinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of radiology State Key Laboratory of Complex Severe and Rare DiseasesPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Nuclear Medicine Beijing Key Laboratory of Molecular Targeted Diagnosis and Therapy in Nuclear MedicineState Key Laboratory of Complex Severe and Rare DiseasesCenter for Rare Diseases ResearchPeking Union Medical College HospitalChinese Academy of Medical Sciences and Peking Union Medical CollegeBeijing 100730China Department of Cardiology The Key Laboratory of Cardiovascular Remodeling and Function ResearchChinese Ministry of EducationChinese National Health Commission and Chinese Academy of Medical SciencesThe State and Shandong Province Joint Key Laboratory of Translational Cardiovascular MedicineQilu HospitalCheeloo College of MedicineShandong UniversityJinanShandong 250012China cardiovascular Disease Research Center of Shandong First Medical University Central Hospital Affiliated to Shandong First Medical UniversityJinanShandong 250013China 不详

Epidemiology of Amyloid Light-Chain Cardiac Amyloidosis(AL-CA)The annual incidence of amyloid light-chain(AL)amyloidosis is 3-5/million,and the incidence in men is slightly higher than that in women.Approximately,70%o... 详细信息

关键词： amyloid cardiac diagnosis

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纳米材料助力合成生物学的生物医学应用

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Science China Materials 2024年第7期67卷 2051-2066页

作者：雷琪赵一帆刘双语肖雅方杨芳郭伟圣顾宁 Department of Minimally Invasive Interventional radiology School of Biomedical Engineering&The Second Affiliated HospitalGuangzhou Medical UniversityGuangzhou 510260China State Key Laboratory of Digital Medical Engineering Jiangsu Key Laboratory for Biomaterials and DevicesSchool of Biological Science and Medical EngineeringSoutheast UniversityNanjing 210096China cardiovascular Disease Research Center Nanjing Drum Tower HospitalAffiliated Hospital of Medical SchoolMedical SchoolNanjing UniversityNanjing 210093China

合成生物学是借助基因工具改造活细胞和生物体的学科,其经历了蓬勃发展阶段,在生物医学领域得到广泛应用,包括新型生物传感器和生物材料设计,以及最新临床治疗药物和疫苗的开发.纳米材料具有独特的物理、化学和生物特性,在拓展合成生物... 详细信息

合成生物学是借助基因工具改造活细胞和生物体的学科,其经历了蓬勃发展阶段,在生物医学领域得到广泛应用,包括新型生物传感器和生物材料设计,以及最新临床治疗药物和疫苗的开发.纳米材料具有独特的物理、化学和生物特性,在拓展合成生物学的生物医学应用场景上具有巨大的潜力,可以提高治疗剂的生产效率,并增强改造生物体的功能.在此,我们简要概述了纳米材料应用于合成生物学领域的最新进展,主要涵盖纳米材料作为递送载体、信号转导器和功能增强剂的角色及其制备过程和性能特点.本综述首先强调了纳米材料作为基因载体的最新成果,包括有机、无机和仿生递送系统;其次,回顾了纳米材料介导的刺激响应型基因表达调控的研究;第三,总结了在可编程的杂化生物活性材料方面的开创性工作,包括纳米材料/细菌杂合系统和纳米材料/哺乳动物细胞杂合系统;最后,讨论了该领域当前面临的挑战,并从个人观点展望了未来的发展前景.

关键词： synthetic biology nanomaterials gene circuit carriers signal transductors hybrid systems

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A machine learning model for diagnosing acute pulmonary embolism and comparison with Wells score,revised Geneva score,and Years algorithm

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Chinese Medical Journal 2024年第6期137卷 676-682页

作者： Linfeng Xi Han Kang Mei Deng Wenqing Xu Feiya Xu Qian Gao Wanmu Xie Rongguo Zhang Min Liu Zhenguo Zhai Chen Wang Capital Medical University Beijing 100069China National Center for Respiratory Medicine State Key Laboratory of Respiratory Health and MultimorbidityNational Clinical Research Center for Respiratory DiseasesInstitute of Respiratory MedicineChinese Academy of Medical SciencesDepartment of Pulmonary and Critical Care MedicineCenter of Respiratory MedicineChina-Japan Friendship HospitalBeijing 100029China Institute of Advanced Research Infervision Medical Technology Co.Ltd.Beijing 100025China Department of radiology China-Japan Friendship HospitalBeijing 100029China Chinese Academy of Medical Sciences and Peking Union Medical College Beijing 100730China Department of radiology Peking University China-Japan Friendship School of Clinical MedicineBeijing 100191China

Background:Acute pulmonary embolism(APE)is a fatal cardiovascular disease,yet missed diagnosis and misdiagnosis often occur due to non-specific symptoms and signs.A simple,objective technique will help clinicians make a quick and precise diagnosis.In population studies,machine learning(ML)plays a critical role in characterizing cardiovascular risks,predicting outcomes,and identifying biomarkers.This work sought to develop an ML model for helping APE diagnosis and compare it against current clinical probability assessment models.Methods:This is a single-center retrospective study.Patients with suspected APE were continuously enrolled and randomly divided into two groups including training and testing sets.A total of 8 ML models,including random forest(RF),Naïve Bayes,decision tree,K-nearest neighbors,logistic regression,multi-layer perceptron,support vector machine,and gradient boosting decision tree were developed based on the training set to diagnose APE.Thereafter,the model with the best diagnostic performance was selected and evaluated against the current clinical assessment strategies,including the Wells score,revised Geneva score,and Years algorithm.Eventually,the ML model was internally validated to assess the diagnostic performance using receiver operating characteristic(ROC)analysis.Results:The ML models were constructed using eight clinical features,including D-dimer,cardiac troponin T(cTNT),arterial oxygen saturation,heart rate,chest pain,lower limb pain,hemoptysis,and chronic heart failure.Among eight ML models,the RF model achieved the best performance with the highest area under the curve(AUC)(AUC=0.774).Compared to the current clinical assessment strategies,the RF model outperformed the Wells score(P=0.030)and was not inferior to any other clinical probability assessment strategy.The AUC of the RF model for diagnosing APE onset in internal validation set was 0.726.Conclusions:Based on RF algorithm,a novel prediction model was finally constructed for APE diagnosis.When compared to the current clinica

关键词： Acute pulmonary embolism Machine learning Wells score Revised Geneva score Years algorithm

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